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Titolo:
GADIA2-COMBI DETERMINATION AS FIRST-LINE SCREENING FOR IMPROVED PREDICTION OF TYPE-1 DIABETES IN RELATIVES
Autore:
DITTLER J; SEIDEL D; SCHENKER M; ZIEGLER AG;
Indirizzi:
HOSP MUNCHEN SCHWABING,DIABET RES INST,DEPT MED 3,KOLNER PLATZ 1 D-80804 MUNICH GERMANY HOSP MUNCHEN SCHWABING,DIABET RES INST,DEPT MED 3 D-80804 MUNICH GERMANY
Titolo Testata:
Diabetes
fascicolo: 4, volume: 47, anno: 1998,
pagine: 592 - 597
SICI:
0012-1797(1998)47:4<592:GDAFSF>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
GLUTAMIC-ACID DECARBOXYLASE; ISLET-CELL ANTIBODIES; INSULIN; IDDM; AUTOANTIBODIES; IDENTIFICATION; CHILDHOOD; ANTIGENS; ASSAY; RISK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
17
Recensione:
Indirizzi per estratti:
Citazione:
J. Dittler et al., "GADIA2-COMBI DETERMINATION AS FIRST-LINE SCREENING FOR IMPROVED PREDICTION OF TYPE-1 DIABETES IN RELATIVES", Diabetes, 47(4), 1998, pp. 592-597

Abstract

A new radiobinding assay for the simultaneous detection of antibodiesto GAD and the tyrosine phosphatase IA2 has been recently described in patients with newly diagnosed type 1 diabetes. Here we assessed sensitivity and predictive value of this GADIA2-combi test in first-degreerelatives of type 1 diabetic patients compared with islet cell antibody (ICA) and insulin autoantibody (IAA) screening. Of 1,606 relatives,77 (4.8%) had elevated GADIA2-combi titers above the 99th percentile of 105 nondiabetic control subjects, and results were confirmed by testing these samples for GAD antibody (GADA) and tyrosine phosphatase IA2 antibody (IA2A) in the single antibody test (29 GADA(+)/IA2A(+), 44 GADA(+)/IA2A(-), and 4 IA2A(+)/GADA(-)). A further 9 of 1,606 relatives had detectable ICA (1) or IAA (8), but they were negative in the GADIA2-combi assay as well as in the single test for GADA or IA2A. Twenty-four relatives progressed to IDDM within a median follow-up time of 5.6 years (range 0.5-8.2). The sensitivity of antibody determination inrelatives with progression to IDDM was 92% for the GADIA2-combi assay, 96% for the combined testing of IAA and GADIA2-combi antibodies, and83, 67, 67, and 79%, respectively, for GADA, IA2A, IAA, or ICA testing alone. The cumulative life-table risk of antibody-positive relativeswas related to GADIA2-combi titers (5-year risk: >50 U, 51% [95% CI 30-73]; >10 to 50 U, 12% [1-24]; <10 U, 0.17% [0-0.5]; P = 0.0001) and on the presence of IA2A in addition to GADA (5-year risk: GADA(+)/IA2A(+), 47% [25-68]; GADA(+)/IA2A(-), 15% [2-28]; P = 0.006). In those with detectable antibodies, risk was not associated with age (less than or equal to 15 vs. >15 years) or relation to proband (offspring, sibling, parent). Relatives with GADIA2-combi antibodies >10 U and the additional presence of IAA had a slightly higher diabetes risk than relatives without IAA (5-year: IAA(+), 46% [23-68]; IAA(-), 19% [6-32]; P = 0.07). Furthermore, low first-phase insulin release after intravenous glucose tolerance test was associated with risk in relatives with GADIA2-combi antibodies (P = 0.01). These results indicate that the GADIA2-combi test is a valuable marker for first-line screening and risk assessment of type 1 diabetes in relatives. It can be used for venous as well as capillary blood samples.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 17:26:33